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The healthy adherer effect has gained increasing attention as a potential source of bias in observational studies examining the association of positive airway pressure (PAP) adherence with health outcomes in OSA.

Background and aimsThe recurrence of obstructive sleep apnoea (OSA) after positive airway pressure (PAP) therapy termination has physiological consequences that may increase cardiovascular (CV) risk. We aimed to determine whether PAP termination is associated with an increased incidence of major adverse CV events (MACE) compared with adherent PAP continuation.MethodsData from the Pays de la Loire Sleep Cohort were linked to the French national health insurance database to identify incident MACE (composite outcome of mortality, stroke and cardiac diseases), and CV active drug (lipid-lowering, antihypertensive and antiplatelet drugs, beta-blockers) adherence (medication possession ratio ≥80%). The association of PAP termination with MACE was evaluated using a time-dependent survival Cox model, with adjustment for confounders including CV active drug status.ResultsAfter a median follow-up of 8 years, 969 of 4188 included patients (median age 58 years, 69.6% men) experienced MACE, 1485 had terminated PAP while 2703 continued PAP with at least 4 hours/night use. 38% of patients were adherent to all CV drugs in the PAP continuation group versus 28% in the PAP termination group (p<0.0001). After adjustment for confounders, PAP termination was associated with an increased risk of MACE (HR (95% CI): 1.39 (1.20 to 1.62); p<0.0001). PAP termination was not associated with incident heart failure and coronary artery disease.ConclusionsIn this multicentre clinical-based cohort involving 4188 patients with OSA, PAP termination compared with adherent PAP continuation was associated with an increased risk of MACE. More research is needed to determine whether support programmes on PAP adherence could improve CV outcomes.

AbstractBackgroundThe current COVID-19 pandemic imposes changes in the management of cardiac pathologies. Cardiac rehabilitation needs to define new protocols to welcome patients back. In connection with the observations of the European Association of Preventive Cardiology, the choice of cardiac tele-rehabilitation appeared to be unavoidable.AimThis retrospective research based on data from the Program for the Medicalisation of Information Systems (PMSI) and the electronic medical record analyzes the effect of Hybrid Cardiac Rehabilitation.MethodsOne hundred and ninety-two patients (29 females and 163 males) with an average of 56.9 years old (±10.3) were able to benefit from a Hybrid Cardiac Rehabilitation program. The data concerning the Stress Test and the Wall Squat Test were collected.ResultsWe have noticed that patients had improved their cardiorespiratory capacity on the initial and final Stress Test 6.6 (±1.8) MET to 8.2 (±1.9) MET (p < 0.0001). We also found that patients improved lower limb muscle strength 75.1 (±44.8) seconds to 105.7 (±49.7) seconds (p < 0.0001).ConclusionsHybrid Cardiac Rehabilitation protocols can be set up in this pandemic situation. The programme effectiveness appears to be comparable to the traditional model. However, additional studies are needed to determine the effectiveness of this programme in the long term.

OBJECTIVE--We tested the hypothesis of an independent cross-sectional association between obstructive sleep apnea (OSA) severity and glycated hemoglobin ([HbA.sub.1c]) in adults without known diabetes. RESEARCH DESIGN AND METHODS--[HbA.sub.1c] was measured [...]

Study objectives: To emphasize epidemiologic, clinical, or radiologic characteristics whose detection could lead to an early diagnosis and to enhance therapeutic efficacy. Patients: Eighty hospitalized patients from 1982 to 1996. [...]

Visible light (VL) can induce pigmentary alterations, especially in dark-skinned individuals, and exacerbate photodermatoses and pigmentary disorders. Currently, there is no standardized method for assessing sunscreen protection against VL. On the basis of a critical review of published in vitro and in vivo methods, a VL photoprotection assessment method based on pigmentation is proposed.

The hardness of AA 2024 is mainly dependent of the precipitation state in the material. This one will vary through the process of friction stir welding (FSW) which generates heat and deformations. The most important effect will be the thermal excursion which greatly affects the nature and the distribution of precipitates and so the mechanical properties of the material. Three Myhr & Grong-type submodels have been used in this study in order to simulate the variation of hardness in AA 2024-T3 FSW welds. These models allowed to simulate the hardening by growth of S-precipitates and the softening by coarsening and dissolution of GPB zones / co-clusters or S-precipitates. Finally, the natural ageing was taken into account following the Robson model. The complete model has been calibrated with isothermal data found in the literature and still has to be optimised. Nevertheless, preliminary results show the coherence of the model when performed on isothermal data. The model has been also applied to predict FSW hardness profiles that are compared to those found in the literature.

Previous studies have yielded inconsistent findings regarding the association between OSA and cancer in humans.

Étudier si les comportements favorables à la santé et l’utilisation des ressources de santé sont associés à l’observance ultérieure de la pression positive continue nocturne (PPC) chez les patients ayant un syndrome d’apnées obstructif du sommeil.

Déterminer si l’arrêt du traitement du SAHOS par PPC est associé à une augmentation de MACE par rapport à la poursuite du traitement par PPC.

Blockade of interleukin (IL)-23 or IL-17 with biologics is clinically validated as a treatment of psoriasis. However, the clinical impact of targeting other nodes within the IL-23/IL-17 pathway, especially with small molecules, is less defined. We report on a novel small molecule inverse agonist of retinoid acid–related orphan receptor (ROR) γt and its efficacy in preclinical models of psoriasis and arthritis. 1-(2,4-Dichloro-3-((1,4-dimethyl-6-(trifluoromethyl)-1H-indol-2-yl)methyl)benzoyl)piperidine-4-carboxylic acid (A-9758) was optimized from material identified from a high-throughput screening campaign. A-9758 is selective for RORγt and exhibits robust potency against IL-17A release both in vitro and in vivo. In vivo, we also show that IL-23 is sufficient to drive the accumulation of RORγt+cells, and inhibition of RORγt significantly attenuates IL-23–driven psoriasiform dermatitis. Therapeutic treatment with A-9758 (i.e., delivered during active disease) was also effective in blocking skin and joint inflammation. Finally, A-9758 exhibited efficacy in an ex vivo human whole blood assay, suggesting small molecule inverse agonists of RORγt could be efficacious in human IL-17–related diseases.

Les programmes d’éducation des centres de réadaptation cardiovasculaire permettent de faire évoluer les comportements de santé.

The outcome of depressive symptoms under CPAP therapy for OSA-hypopnea syndrome (OSAHS) has been poorly evaluated. In this multicenter, prospective cohort study, we evaluated the prevalence and correlates of persistent depressive symptoms after long-term CPAP therapy for OSAHS.

There is growing evidence from animal models that intermittent hypoxemia (IH) may induce dyslipidemia. Altered lipid metabolism may contribute to the increased cardiovascular risk observed in obstructive sleep apnea (OSA). In this multisite, cross-sectional study, we tested the hypothesis that there is an independent association between nocturnal IH and dyslipidemia in OSA.

In the present work, thermal cycles measured with thermocouples embedded in specimens are employed to validate a numerical thermometallurgical model of an Electron Beam welding process. The implemented instrumentation techniques aim at reducing the perturbations induced by the sensors in place. The numerical model is based on the definition of a heat source term linked to the keyhole geometry predicted by a model of pressure balance using the FEMLAB code. The heat source term is used by the thermometallurigal simulation carried out with the finite element code SYSWELD. Kinetics parameters are extracted from dilatometric experiments achieved in welding austenitization conditions at constant cooling rates.

AbstractThe blood supply to the skin is provided by a network of arterioles, capillaries and venules organized into a superficial and a deep plexus. The assessment of skin microcirculation is of valuable interest in cosmetology in the quantification of the sun protection factor, skin irritation and efficacy of antiredness treatments. Skin microcirculation can be measured by means of different techniques, based mainly on the quantification of optical and thermal properties of the skin which are modified by the amount of blood perfusion. Relevant and reproducible data can be obtained only through the understanding of the biophysical background of the technique(s) utilized. Standardization of measuring conditions and procedures is particularly required for blood flow assessment. In this paper, the advantages and disadvantages of the main techniques in use are discussed, and optimization of measurements for laser Doppler techniques is described.Copyright © 2002 S. Karger AG, Basel

Besides Earth, Mars is the only planet with a record of resurfacing processes and environmental circumstances that indicate the past operation of a hydrologic cycle. However the present-day conditions on Mars are far apart of supporting liquid water on the surface. Although the large-scale morphology of the Martian channels and valleys show remarkable similarities with fluid-eroded features on Earth, there are major differences in their size, small-scale morphology, inner channel structure and source regions indicating that the erosion on Mars has its own characteristic genesis and evolution. The different landforms related to fluvial, glacial and periglacial activities, their relations with volcanism, and the chronology of water-related processes, are presented.

Both humoral and cellular immunodefense responses of the earthworms, Eisenia fetida andrei, Eisenia hortensis, and Lumbricus terrestris, have been compared after exposure to the PCB Aroclor 1254. Responses mediated by free factors, detected by in vitroassays for lysozyme, hemolysis, and proteases, were increased in both Eisenia. Antibacterial activity directed against pathogenic bacteria was increased in E.f. andrei. The resistance of L. terrestrisagainst nonpathogenic bacteria was decreased, confirming that the bacteria were treated by different systems according to their pathogenicity. Nonspecific cellular functions, including phagocytosis and those related to wound healing, decreased dramatically in all earthworms.

Terrestrial grabens and continental rifts are compared with the Valles Marineris system, in order to define the mechanisms which could be responsible for its geometry and formation. Simple shear/pure shear mechanisms, symmetric/asymmetric grabens and faults, high/low dip angles, block tilting/no block tilting, shouldering or not, lithospheric layering, and amount of sedimentation on chasma floors are discussed. Amounts of stretching on several transverse topographic profiles are then calculated, assuming either block tilting or no block tilting. On each profile initial dip angles ranging from 40 to 90, and sediment thicknesses ranging from 0 to 3 km are considered, as well as symmetric and asymmetric border fault dips. The case of Ius Chasma, the southwestern trough of the Valles Marineris system, is first considered, then the entire graben system. Considering a constant 660 km profile length, stretching increases eastward in Ius Chasma from the Noctis Labyrinthus boundary (stretching factor β = 1.01–1.02, assuming initial 60 dipping faults) to the middle part of this trough (β = 1.04–1.06). Then Ius Chasma stretching decreases, but is partly taken over by stretching in Candor and Ophir chasmata. Stretching decreases from the eastern part of Melas Chasma (β = 1.05–1.06) to almost the eastern end of Coprates Chasma (β = 1.01). Then stretching increases again eastward (β = 1.02–1.04) at the longitude Coprates Chasma splits around a horst and Gangis Chasma opens northward. A striking feature is that a low peak of extension in the centre of the Valles Marineris troughs is observed (β = 1.03–1.04). The low stretching peak in the central part of Valles Marineris may originate from the existence of buried structures in the grabens, and/or along-strike variations in sediment thickness. According to the profiles and to the hypotheses, some 9–26 km of additional normal movements along faults with dip angles equivalent to the dip angles of the walls would be expected within the central Valles Marineris grabens to get constant stretching from Ius to Coprates chasmata. The amount of this lacking offset may be partly explained by a few km subsidence of Ophir Planum, and the shallow inter-chasmata grabens. Part of the remaining lacking normal movements are best explained by buried structures (possibly shallow horst and graben alternances or other structures) in the major canyons: Melas, Candor, and/or Ophir chasmata—probably mainly in Melas Chasma. Alternatively, along-strike variations of sediment thickness (about 3 km) without taking such buried structures into account, can explain the results as well. Observation of images shows up that the most realistic structural model of Valles Marineris should probably consider both variations of sediment thicknesses and existence of buried structures. Models for the origin of Valles Marineris stretching are discussed. The role of passive rifting in crust weakened by hot spot is emphasized, although extensional stresses due to the Tharsis load should have also contributed to stretching.

The main aspects of the Martian stratigraphy have been determined from the detailed study of Mariner 9 and Viking Orbiter images. Three major stratigraphic systems, the Noachian System, the Hesperian System, and the Amazonian System, are inferred from these studies. The global geological evolution of Mars is essentially derived from its stratigraphy. It reveals that tectonism and volcanism were widespread during two major periods (Noachian and Lower Hesperian) and became more localized during the Upper Hesperian and Amazonian periods. The transition between these two major periods occurred about 2 Ga ago, and significant geologic activity could still be present. However, a number of geologic features and processes remain little understood. Future investigations, including complete high resolution imaging and detailed mapping, geochemical mapping, in situ chemical analyses, etc., will be necessary in order to improve our knowledge of the Martian stratigraphy and geologic evolution and are essential to prepare any future Mars Sample Return mission and the Human Exploration of this planet.

An inventory of tectonic trends observed in the MC 17 (Phoenicis Lacus) and MC 18 (Coprates) Mars quadrangles, has been constructed on the basis of Mariner 9 and Viking Orbiter images, with regard to their structural significance within the martian history. A scenario for the principal periods and their mechanisms, is proposed with regard to the uplift of the Tharsis Montes-Syria Planum dome.

Human copper-zinc superoxide dismutase (Cu,Zn-SOD) participates in the control of reactive oxygen intermediate intracellular concentration. In this study, we show that phorbol 12-myristate 13-acetate (PMA) increases Cu,Zn-SOD mRNA expression within 30 min. The sequence between nucleotides −71 and −29 is essential for both basal and PMA-induced gene expression. This region includes an Sp1-binding site that is also recognized by a possible Sp1-like protein and by Egr-1 in a PMA-inducible manner. Egr-1 and two splicing variants of the Egr-related protein WT1 were able to transactivate the SOD1promoter in co-transfection experiments. Sp1 and the possible Sp1-like proteins bind to two overlapping, but distinct sequences. However, Egr-1 and Sp1 seem to interact with two sites that are either identical or very close to each other. None of these sites fit the consensus sequences previously reported for these proteins. Analysis of various mutants of theSOD1proximal promoter revealed that the region that binds Sp1 and Egr-1 is required for both basal and Egr-1-driven expression. Interplay between different members of the Sp1 family, Egr-1, and different splicing variants of WT1 in the SOD1proximal promoter may provide clues about the physiological function of Cu,Zn-SOD.

The geologic evolution of the Jovian and Saturnian satellites is reviewed with regard to the major discoveries of the Voyager 1 and 2 encounters with Jupiter and Saturn.

Little scaled studies on the entire planet Mars, and large scale studies of a local area (3600 km in diameter) seem to indicate geographic relations between martian fiuidized craters and ridges: all the intensely ridged areas exhibit a lot of fluidized craters. Because the presence of fluidized craters indicates low viscosity states of the martial surface, this relation would indicate that the compressive stresses only induced ridges when they occurred at times and places of low viscosity states of the martian surface.

The geometry of the furrows of Galileo Regio indicates that they are not of impact origin, and irrelevant to discussion about large impact effects. The detailed study of three large impact basins indicates that their transient cavity radii are different from previously reported values. Because of the relations between crater's size and lithospheric thickness, these new values of basins radii would constrain further models of Ganymede's thermal evolution. The geometry of lineaments around these three basins, which occurred on grooved terrains, indicates that these impacts induced tectonic motions along a preexisting planetary wide grid pattern. This pattern influenced also the formation of the furrows on Galileo Regio. That would indicate that the grooved terrains are only superficial layers and that they were formed without destruction or rotation of their basement.

β-D-Xylosides are known to initiate or prime free glycosaminoglycan (GAG) chain synthesis in cell and tissue culture. As such, the effect of the venous antithrombotic β-D-xyloside, naroparcil, was investigated on the plasma GAG profile in the rabbit after oral administration. Using dose-response experiments, we showed that antithrombin activity via antithrombin III and heparin cofactor II was increased in parallel with GAG plasma levels compared to control. A more detailed qualitative examination of plasma GAGs by cellulose acetate electrophoresis and ion-exchange chromatography, following oral administration of naroparcil at 400 mg/kg, revealed the presence of higher density charged molecules compared to control. The extracted GAGs were found to activate inhibition of thrombin by heparin cofactor II and contained approximately 25% of a dermatan sulfate-like compound (undetectable in control), which could be responsible for the antithrombotic effect. Using radiolabeled naroparcil, we found radiolabeled GAG fractions and the fact that naroparcil was a substrate for galactosyltransferase I, the second enzyme responsible for GAG chain polymerization, suggested that the compound could initiate in vivothe biosynthesis of antithrombotic free GAG chains. This is, to our knowledge, the first description of the in vivoeffect of a β-D-xyloside on GAG biosynthesis; furthermore, this is correlated with an antithrombotic action.

Déterminer si l’association entre la sévérité du syndrome d’apnée hypopnée obstructif du sommeil (SAHOS) et le contrôle glycémique diffère chez des patients avec un diabète de type 2 (DT2) nouvellement diagnostiqué, non traités et chez des patients DT2 traités.

Trapped field magnets have been investigated using Zr-added (Gd,Y)Ba-Cu-O thin film superconductor tapes. Trapped field profiles were examined both experimentally and by simulation over a temperature range of 30 to 77 K. A good match is found between experimental and simulation trapped field data at 77 K and 65 K, but higher trapped field values were obtained experimentally at lower temperatures. Trapped field values up to 1.55 T were measured in an 11 mm thick stack of 55 um thick superconductor tapes arranged in a crisscross fashion with three tapes per layer. A substantial increase in the trapped field values was found by simulation, in tape stacks made with 20 um thick tapes. Using such thin tapes, trapped field values of nearly 2 T is predicted in [?] 13 mm thick tape stacks at 77 K.

Inhibition of proteoglycan (P) synthesis by β-D xylosides (Xyl) is associated with growth inhibition in several cultured vascular cell lines. We examined the effects of naroparcil (an orally active Xyl) on intimal hyperplasia induced by balloon iliac injury in hypercholesterolemic rabbits.